Summary & Overview
HCPCS Level II A4340: Specialty Indwelling Urinary Catheter, Each
HCPCS Level II code A4340 represents a specialty indwelling urinary catheter (examples: coude, mushroom, wing), billed per device. This durable medical equipment code is relevant nationwide because indwelling catheters are commonly supplied for chronic urinary retention, neurogenic bladder, or post-surgical management, creating consistent utilization across outpatient, home health, and clinic settings. Payers commonly involved in coverage and reimbursement for this equipment include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will learn the clinical context for use of specialty indwelling catheters, which sites of service typically supply them, and the scope of payers considered in the analysis. The publication provides benchmarks and policy-relevant details where available, clarifies coding context for billing teams, and outlines areas where payer coverage language or documentation requirements commonly affect claims. Data not available in the input will be noted where applicable.
Billing Code Overview
HCPCS Level II code A4340 describes an indwelling catheter; specialty type (for example, coude, mushroom, wing, etc.), billed per device. Service type: ** durable medical equipment supply — specialty indwelling urinary catheter**. Typical site of service: home health, outpatient clinics, and other non-inpatient settings where durable medical equipment is supplied to the patient.
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Clinical & Coding Specifications
Clinical Context
A typical patient is an adult male with urinary retention due to prostatic obstruction and a history of failed intermittent catheterization who requires placement of a specialty indwelling urinary catheter (for example, a coude catheter) in an outpatient urology clinic. The workflow begins with evaluation of lower urinary tract symptoms, bladder scan demonstrating significant post-void residual, and discussion of catheter options. The clinician selects a specialty-type indwelling catheter when anatomical factors (enlarged prostate, urethral stricture, or difficulty passing a straight-tip catheter) require a curved or tapered tip such as a coude or mushroom catheter. The device is opened, lubricated, and inserted using sterile technique; if needed, local anesthetic or topical antiseptic is applied. The catheter is secured, balloon inflated per manufacturer instructions, and urine drainage verified. Patient education on catheter care, signs of infection, and a follow-up plan are provided. Typical settings include outpatient urology or primary care clinics, emergency departments, and skilled nursing facilities when ongoing bladder drainage is required.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional component of a bundled service related to catheter placement when separated from technical supplies. |